Understanding what’s coming and putting a plan in place to meet the overall objective requires knowing your level of responsibility, putting the necessary tools into place, validating the data is accurate and submitting it within the required deadline.

Preparation is crucial to your ability to meet the ACA and PBJ compliance requirements successfully. This means identifying the solutions you need and investing in operational systems, resources, and providing the training your staff needs.

Implementation can make or break the execution of your solutions, and ultimately your ability to satisfy your compliance obligations. So you need to have the right tools in place and ensure the right people are managing them.

Operations is a vital component of your continued success. You need to ensure that continued education, training & support occurs regularly to ensure you’re able to remain compliant with ongoing reporting requirements and to stay current with any updates that will impact your ability to meet future reporting requirements.

The Impact of Payroll Based Journal Reporting

PBJ will affect staffing, operational costs, and your projected revenue goals. Unfortunately, you cannot eliminate the cost, but you can control how you proactively manage the reporting process that will ultimately minimize the overall cost involved.

By putting in place the solutions that will ensure you meet the reporting requirements that show your facility is providing quality of care you minimize the risk of delayed reporting, penalties, etc.

Know Your Responsibility

Understanding your responsibility for Payroll Based Journal reporting is the first step to successfully meeting the requirements as mandated by the Centers for Medicaid & Medicare Services (CMS).

All long-term nursing facilities are required to provide specific employee data for all of their direct care staff as well as their residents’ census data—Medicare, Medicaid, or other.

Effective July 1, 2016, the PBJ reporting will be mandatory.

The employee specific data required is as follows:

– a unique employee ID for each direct staff care provider (no SSN’s allowed)
– a complete, accurate record for each facility that identifies their direct care staff (Includes agency and contractors too)
– include medical personnel as defined by CMS (RN, PT, LPN, etc.)
– direct care staff turnover and tenure (date of hire and term dates)
– hours of care provided by each category of staff per resident per day including start and end date and the hours worked per individual

This information is critical for CMS to set an effective a standard that will enable them to rate long-term nursing facilities’ quality of care.

Meeting the PBJ Reporting Requirements

You have one more voluntary reporting quarter before PBJ reporting becomes mandatory. This means you need to be sure you understand the reporting requirements and get the tools you need in place quickly.

The Centers for Medicaid & Medicare Services (CMS) strongly recommend that you take advantage of the voluntary submission quarter to get your reporting in sync with the Quality Improvement and Evaluation System (QIES).

QIES Did You Know?

– QIES allows only two logins per facility (they time out after 15 minutes of inactivity).
– While in QIES you will NOT be able to copy and paste your data from other resources… if you do not have a file to upload, then it is truly going to be manual data entry.
– You will need to have a way of generating unique IDs for your direct care staff, agency, and contractors. You can reuse IDs for the same individual, but not for others (ex. employee leaves employment and returns then you can reuse the ID they had previously).
– You will need to map job titles to the CMS defined codes to ensure they are in sync for reporting purposes.
– In the case of an audit, you will need to have a record of all the reported hours of your direct care staff, agency, and contractors so that you can verify your PBJ reporting.
– You have three options for submitting your PBJ data: manually enter it into the QIES system, file submission (XML zip file format only) or upload a file and then enter in the remaining or missing data manually.
– There is not a “test” period, but you can use the voluntary submission period to submit files and check for errors, etc. (this is strongly recommended)

Registering Your Long-Term Nursing Facility for PBJ

Starting July 1, 2016, Payroll Based Journal reporting will be mandatory for all long-term nursing facilities.

The Centers for Medicaid & Medicare Services (CMS) system for entering long-term nursing facility data is Quality Improvement and Evaluation System (QIES).

You will need to provide direct care staff information and resident census data on a quarterly basis. You have 45 days after a quarter ends to submit your Payroll Based Journal reporting.

If you don’t already have your facility registered and the tools in place to help you meet the PBJ reporting requirements, now is the time to get everything in place. Right now it’s considered the voluntary period. July 1, 2016 PBJ reporting will be mandatory.

How to Successfully Submit PBJ Reporting

The required data for direct staff is as follows:

– a unique employee ID for each direct staff care provider (no SSN’s allowed)
– a complete, accurate record for each facility that identifies their direct care staff (Includes agency and contractors too)
– include medical personnel as defined by CMS (RN, PT, LPN, etc.)
– direct care staff turnover and tenure (date of hire and term dates)
– hours of care provided by each category of staff per resident per day including start and end date and the hours worked per individual

You have three options for submitting your PBJ data: manually enter it into the QIES system, file submission (XML zip file format only) or upload a file and then enter in the remaining or missing data manually.

How to Improve Your PBJ Reporting

Payroll Based Journal reporting consists of three parts: 1) direct care staff information 2) resident Census data and 3) the process of uploading your data into the Quality Improvement and Evaluation System (QIES).

You’ll want to be sure the medical staffing titles you pass to QIES matches what The Centers for Medicaid & Medicare Services (CMS) uses. This is referred to as mapping and is crucial to the data passing through without errors. For reporting purposes, you may need to map to a title that is closest to your internal titles or job descriptions.

The required timekeeping data is for each direct care staff employee, per day and per category of work. We strongly suggest implementing an automated timekeeping solution such as TimeWorksPlus. The timekeeping data is used to determine your facilities quality of care, based on a five-star rating system. You will need to be sure the data you submit is also auditable in the event you’re audited.

Using a file to upload your PBJ data is best. This ensures the data is accurate by minimizing human errors. It is also the fastest way to enter the data into QIES. If you have missing data once you upload the file, you can always enter additional data manually to create a complete file for submission.

3 Common PBJ Reporting Mistakes

Mistakes are opportunities for growth so why not use others’ mistakes to improve your PBJ reporting.

1. Manual data entry– is responsible for creating avoidable data errors. So why enter your PBJ data manually when you can implement an automated timekeeping solution to not only track employees hours and the work they perform but also create records that are auditable in the event of an audit.

2. Mismatched employee data– employee titles must match the standard titles used by the Centers for Medicaid & Medicare Services (CMS). If they do not, they will error and may hinder you from submitting your PBJ report in time.

3. Unacceptable report format– when submitting your data you must upload it in an XML zip file format only.

To ensure your submission is acceptable the CMS strongly recommends that you take advantage of the voluntary submission period to get your reporting in sync with the Quality Improvement and Evaluation System (QIES).

Avoiding PBJ Penalties

Learning the ABC’s of the Payroll Based Journal reporting requirements is a preventative measure to avoiding PBJ penalties.

– Accurate data- you must ensure the information for your direct staff and your resident census data is correct.

– Back up data- in the event of an audit, you must have your records available to verify the PBJ data you submitted.

– Complete data- the report submission must be complete with all of the required data fields as defined by the Centers for Medicaid & Medicare Services (CMS).

PBJ and the Solutions You Need

I know PBJ reporting must sound like a daunting task to tackle. Well, you are not alone. But don’t worry, SwipeClock’s Workforce Management Suite solution can help make this process easier for you.

SwipeClock’s Workforce Management Suite— the Solutions You Need

TimeWorksPlus is our automated timekeeping system that not only tracks employee hours to the minute, but it also enables you to set up job codes to track what your employees are doing and for how long. It has a built-in audit trail that enables you to meet the demands of an audit.

TimeSimplicity is our advanced scheduling system that tracks shift coverage and proactively identifies gaps in required staffing as mandated for providing quality of care. Communication is key, and with TimeSimplicity’s text and email collaboration and its Trade Board features, it enables employees and managers to have clear lines of communication to resolve staffing issues within a few minutes.

TimeWorks Mobile is the trusted mobile companion to TimeWorksPlus. It enables employees to punch in or out via their mobile device, which means the necessary tracking of hours never skips a beat even while your employees are working off-site.

☒ ☐ Work Week and Work Month reports (calculation of employee status reports)

☒ ☒ Employee status (FT, PT)

☒ ☒ Staffing and schedule management

☒ ☒ Communication/collaboration via email & text

☒ ☒ Mobile access to punch IN/OUT (via mobile device & WebClock)

☒ ☒ Dashboard— accrued & total overtime hours

☒ ☒ Timekeeping data records

☒ ☒ Hours’ threshold indicator

☒ ☒ Timecard approvals

☒ ☒ Finalized pay period (lock-down data)

☒ ☒ Employee groups

☒ ☒ Time card audit

☒ ☒ Manageable, editable time cards (with audit trail)

☐ ☒ Certification tracking/expiration (RN, PT, LPN, etc.)

☒ ☒ Alert indicators (overtime, max hours, etc.)

We’re excited to share that coming the first part of Q2 2016 we will have our new PBJ file format available via our TimeWorksPlus system. It will provide the timekeeping data needed for importing into the Quality Improvement and Evaluation System (QIES).

Don’t Miss the PBJ Reporting Deadline

July 1, 2016 is the first quarter that PBJ reporting will be mandatory, meaning the period for data to be submitted will be from July 1, 2016, to September 30, 2016, with the first mandatory submission to the PBJ system due by no later than 45-days after the quarter ends which is November 14, 2016.

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